Individual provider Active NPI

Sara Mangas, NP-C

  • Nurse Practitioner
  • Kettering, OH
National Provider Identifier
1285006619
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
COA.18331-NP Issued in OH
Practice address
3535 Southern Blvd
Kettering, OH 45429-1221
Phone
(937) 395-8166
NPI assigned
Oct 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.18331-NP OH Primary

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429-1221

Mailing address

3131 Newmark Dr Ste 220
Miamisburg, OH 45342-5400
Phone (937) 436-4658

Other practice location 1

1141 N Monroe Dr
Xenia, OH 45385-1619
Phone (937) 352-2500

Other practice location 2

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone (937) 384-8791

Other practice location 3

8701 Old Troy Pike
Huber Heights, OH 45424-1066
Phone (937) 558-3338

Other practice location 4

100 Kettering Way
Franklin, OH 45005-1155
Phone (937) 458-4700

Other practice location 5

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4500

Other practice location 6

1997 Miamisburg Centerville Rd
Centerville, OH 45459-3811
Phone (937) 401-6228

Other practice location 7

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 723-3211

Other practice location 8

450 Washington Jackson Rd Ste F
Eaton, OH 45320-8699
Phone (937) 456-8376

Other practice location 9

600 W Main St
Troy, OH 45373-2928
Phone (937) 980-7010

Other practice location 10

6147 State Route 122
Middletown, OH 45005-5201
Phone (513) 261-3410

Other identifiers 1

IdentifierTypeStateIssuer
0150449MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151203002804 OH Practitioner - Nurse Practitioner 7618277294 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.18331-NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Specialists, Inc Nurse Practitioner CurrentSince Nov 19, 2015 Accepting new patients
Emergency Medicine Specialists Inc Nurse Practitioner CurrentSince Nov 19, 2015 Accepting new patients
Emergency Medicine Specialists Inc Nurse Practitioner Current Accepting new patients
Emergency Medicine Specialists Inc Nurse Practitioner Past Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

450 Washington Jackson Rd
#F
Eaton, OH 45320
Phone (937) 456-8376

100 Kettering Way
Franklin, OH 45005
Phone (937) 458-4700

8701 Troy Pike
Huber Heights, OH 45424
Phone (937) 558-3309

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342
Phone (937) 384-8791

3131 Newmark Dr
Ste 220
Miamisburg, OH 45342

6147 State Route 122
Middletown, OH 45005
Phone (513) 261-3410

600 W Main St
Troy, OH 45373
Phone (937) 395-6665

1997 W Centerville Rd
Washington Township, OH 45459
Phone (937) 401-6000

1141 N Monroe Dr
Xenia, OH 45385
Phone (937) 352-2000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1285006619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 NEWMARK DR STE 220",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425400",
            "telephone_number": "937-436-4658",
            "fax_number": "937-436-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-8166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1141 N Monroe Dr",
            "address_purpose": "LOCATION",
            "city": "Xenia",
            "state": "OH",
            "postal_code": "453851619",
            "country_code": "US",
            "telephone_number": "937-352-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8701 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241066",
            "country_code": "US",
            "telephone_number": "937-558-3338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "OH",
            "postal_code": "450051155",
            "country_code": "US",
            "telephone_number": "937-458-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1997 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454593811",
            "country_code": "US",
            "telephone_number": "937-401-6228",
            "fax_number": "937-401-6447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-3211",
            "fax_number": "937-723-4609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Washington Jackson Rd Ste F",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453208699",
            "country_code": "US",
            "telephone_number": "937-456-8376",
            "fax_number": "937-456-8377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 W Main St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453732928",
            "country_code": "US",
            "telephone_number": "937-980-7010",
            "fax_number": "937-980-7019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6147 State Route 122",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450055201",
            "country_code": "US",
            "telephone_number": "513-261-3410",
            "fax_number": "513-261-3419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGAS",
        "first_name": "SARA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.18331-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150449",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.